Sesame Seed Allergens

• Ses i 1 - 2S albumin
• Ses i 2 - 2S albumin
• Ses i 3 - 7S vicilin-like globulin
• Ses i 4 - oleosin
• Ses i 5 - oleosin
• Ses i 6 - 11S globulin
• Ses i 7 - 11S globulin

Note:

• Oleosins are structural proteins found in plant cell oil bodies (oil bodies are lipid-containing structure found in plant cells)
• Common food allergen in countries where it is regularly consumed (Japan, Israel, Europe) and it is becoming more common in the US

Sesame Seed Allergen Cross-reactivity

Diagnosis

Method	Comment
SPT	Commercial extracts - may be sufficient for detection of water soluble sesame proteins Fresh prick to prick with: Sesame seed crushed in saline Commercial sesame oil (e.g. Crudigno brand)
Immediate skin contact test	May allow better detection of oleosin-sensitized patients Apply a square of filter paper (10x10 mm) dipped in sesame oil (Crudigno) on the volar side of the forearm and remove it after 20 minutes
In-vitro specific IgE	Thermo Scientific (Phadia): Sesame seed (complete allergen) - ImmunoCAP nSes i 1 (component) is included in ISAC microarray
Oral food challenge	Sampson: challenge to sesame if sIgE is ≤20 kUA/L; avoidance if >20 We will perform a challenge in patients with sIgE >20 if the patient/family would like to have sesame in the diet If the skin test is negative, sesame may be introduced into the diet

Note: Sesame oil differs from the others because it is typically available as an unrefined, crude oil, which contains a significantly higher amount (3-13 mg/g) of proteins

Sesame Seed Allergy Monitoring

Sesame OFC Protocols

• Dalal, Sampson: patients may tolerate the sesame seed but react to sesame-based spreads and sauces. Thus, it is important to educate these patients that the ability to eat sesame- topped bread does not imply a tolerance to other sesame-based products.

Kanny

• Challenge material: sesame seeds
• Interval: 30 min
• Total dose: 16.55 g
  • 0.05 g
  • 0.5 g
  • 1 g
  • 5 g
  • 10 g

HealthNuts

• Designed for 1 year old infants
• Challenge material: Unhulled tahini (Mayver’s, Altona North, Victoria, Australia). After the initial dose, the allergen is mixed with an age-appropriate previously tolerated food (eg, apple sauce or yogurt) on the basis of preferred parental choice of food.
• Interval: 20 min
• Total dose: 9.7 mL tahini (11.3 g)
  • Drop inside lip (not to touch outside lip)
  • 0.31 mL
  • 0.62 mL
  • 1.25 mL
  • 2.5 mL
  • 5 mL

Permaul

• Challenge material: sesame seeds
• Interval: 15 min
• Children ≥3 yo
  • 100 mg
  • 500 mg
  • 1 g
  • 2 g
  • 4 g
  • 4 g
• Children <3 yo
  • 500 mg
  • 1 g
  • 2 g
  • 4 g

References